Ge­netic testing could soon be uti­lized by firms to aid work­ers in shed­ding pounds

Your em­ployer may one day help de­ter­mine if your genes are why your jeans have be­come too snug.

Big com­pa­nies are con­sid­er­ing blend­ing ge­netic testing with coach­ing on nu­tri­tion and ex­er­cise to help work­ers lose weight and im­prove their health be­fore se­ri­ous con­di­tions like di­a­betes or heart dis­ease de­velop. It’s a step be­yond the typ­i­cal cor­po­rate well­ness pro­grams that many com­pa­nies are us­ing to make work­ers more aware of their risk fac­tors and im­prove their health.

Ge­netic testing in cor­po­rate well­ness pro­grams also is rel­a­tively un­charted ter­ri­tory. Many em­ploy­ers and in­sur­ers cover th­ese tests and coun­sel­ing for med­i­cal rea­sons, like help­ing peo­ple de­ter­mine if they are more prone to cer­tain can­cers. And ear­lier this year, Pres­i­dent Obama asked Congress to ap­prove spend­ing on med­i­cal re­search into us­ing a pa­tient’s genes to tai­lor care.

Mix­ing generic testing into a well­ness pro­gram may cre­ate a tool at­trac­tive to em­ploy­ers des­per­ate to cut health care costs, one of the big­gest ex­penses in a com­pany’s bud­get. But em­ployee benefits ex­perts have doubts that such a novel ap­proach will gain mo­men­tum. It first has to con­quer steep chal­lenges like em­ployee worry about shar­ing such sen­si­tive in­for­ma­tion and em­ployer skep­ti­cism about its ef­fec­tive­ness.

“They are wait­ing for ev­i­dence that this ge­netic testing will change risks,” said Dr. Jeff Levin-Scherz, a se­nior con­sul­tant with the benefits con­sult­ing firm Tow­ers Wat­son.

Spark­ing the push to add ge­netic testing into cor­po­rate well­ness of­fer­ings is a new pro­gram from the health in­surer Aetna and New­topia, a small Canadian com­pany that cre­ates per­son­al­ized health-im­prove­ment pro­grams. Their of­fer­ing uses data from ini­tial well­ness pro­gram steps like phys­i­cals or blood tests to fig­ure out which em­ploy­ees are vul­ner­a­ble to meta­bolic syn­drome.

That’s a group of con­di­tions like high blood sugar, poor choles­terol or a big waist­line that, when they oc­cur to­gether, in­crease a pa­tient’s risk for heart dis­ease, stroke and di­a­betes.

Those peo­ple are in­vited to get testing that an­a­lyzes a nar­row band of genes that can tell pa­tients things like how their body pro­cesses car­bo­hy­drates or fats, or if they have a ge­netic marker tied to com­pul­sive eat­ing. Pa­tients then work with a coach to com­bine that in­for­ma­tion with a plan to im­prove their health.

Aetna and New­topia are sell­ing their pro­gram to the in­surer’s big­gest em­ployer cus­tomers, and they are seek­ing to sign up to six com­pa­nies this year. Spokes­woman Michelle Grant said the cost for com­pa­nies will be on par with other dis­ease pre­ven­tion pro­grams that at­tempt to im­prove a per­son’s health us­ing live, in­di­vid­ual coach­ing and apps. She did not pro­vide specifics.

Aetna ap­pears to have this niche to it­self for now. None of the other ma­jor health in­sur­ers in the United States of­fer ge­netic testing as part of a well­ness pro­gram.

The new pro­gram was tested on em­ploy­ees at Aetna and The Jack­son Lab­o­ra­tory, a Bar Har­bor, Maine, com­pany. Scott Craig, a main­te­nance worker at the lab­o­ra­tory, de­cided to give the test a shot last year be­cause his weight had soared to 335 pounds and his blood pres­sure and blood sugar lev­els were up.

The 53- year- old mailed a saliva sam­ple in for anal­y­sis. The re­sult? He has no ge­netic traits that help ex­plain his weight gain.

“In other words, I got noth­ing to blame,” he said. “Find­ing that out, oddly enough, seemed to mo­ti­vate me.”

Craig con­nected with the pro­gram’s health coach, who helped him fig­ure out how to squeeze in ex­er­cise three times a week and im­prove his diet. New­topia also started send­ing per­son­al­ized vi­ta­min sup­ple­ments and of­fer­ing on­line con­tests that taught Craig how to track his daily ac­tiv­i­ties and think of ev­ery­thing he did as a way to burn calo­ries.

Craig was one of 130 lab­o­ra­tory em­ploy­ees in­vited to try the pro­gram. A to­tal of 28 started. More than a year later, only 19 still par­tic­i­pate. Most have lost 7 per­cent of their body weight or more, said Wayne Gregersen, who works in the com­pany’s com­pen­sa­tion and benefits depart­ment.

Gregersen, who es­ti­mates that the pro­gram costs US$400-600 more per per­son than a sim­i­lar, high-end health coach­ing op­tion, liked the re­sults. But he said the com­pany must learn why par­tic­i­pa­tion was so low, es­pe­cially since the lab­o­ra­tory fo­cuses on ge­netic re­search.

He also said he has a hard time un­der­stand­ing the value of ge­netic testing but plans to give the Aetna-New­topia pro­gram an­other year.

It may take sev­eral years be­fore a com­pany sees a drop in health care costs from changed em­ployee be­hav­ior, said Rose Stan­ley, a prac­tice leader at Worl­dat­Work, a non­profit hu­man re­sources as­so­ci­a­tion.

Com­pa­nies have to at­tract work­ers who will not only re­al­ize that they have a prob­lem but also will work to fix it even if they fail at first, Stan­ley said.

But be­fore com­pa­nies can even see re­sults, they have to sign up em­ploy­ees. That’s a chal­lenge for any well­ness pro­gram, let alone one that in­cludes ge­netic testing.

Many em­ploy­ees just don’t like shar­ing per­sonal de­tails, and ge­netic in­for­ma­tion car­ries a lot of po­ten­tial for abuse, said Lisa Sch­lager, a vice pres­i­dent of com­mu­nity af­fairs with Fac­ing Our Risk of Can­cer Em­pow­ered, a non­profit ad­vo­cacy group for peo­ple with hered­i­tary dis­po­si­tions to can­cer.

She said any ge­netic in­for­ma­tion col­lected for a well­ness pro­gram should be used in a limited scope, and the plan must come with strong pro­tec­tions to keep em­ploy­ers from see­ing an in­di­vid­ual’s re­sults and pe­nal­iz­ing work­ers.

“That’s where peo­ple are start­ing to get a lit­tle ner­vous,” she said.

New­topia runs the well­ness pro­gram and doesn’t share an in­di­vid­ual’s re­sults with ei­ther the em­ployer or the in­surer, com­pany CEO Jeff Ruby said.

A fed­eral law also protects against ge­netic dis­crim­i­na­tion in health in­sur­ance and em­ploy­ment.

In ad­di­tion to em­ployee con­cerns, there are ques­tions about whether ge­netic testing can be help­ful in deal­ing with meta­bolic syn­drome. Mayo Clinic en­docri­nol­o­gist Dr. Michael Jensen says, as far as he knows, ge­netic testing isn’t used as part of care.

He said ge­netic fac­tors linked to obe­sity are hard to an­a­lyze, and more than 95 per­cent of weight gain is tied to fac­tors like diet or ex­er­cise.

“Genes don’t ex­plain that much of the vari­abil­ity,” he said.

Still, ge­netic testing could mo­ti­vate some to im­prove their health, even if it sheds lit­tle light on their con­di­tion. Craig, the Jack­son Lab­o­ra­tory worker, has dropped 50 pounds since he started work­ing with his health coach.

“I’ve come a long way since then,” he said. “Two hun­dred eighty- five pounds may sound like a lot to you, but to me it’s re­ally good.”